The effects of 8 months of metformin on circulating GGT and ALT levels in obese women with polycystic ovarian syndrome: PCOS, NAFLD and metformin therapy
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CONTEXT: The prevalence of non-alcoholic fatty liver disease (NAFLD) in polycystic ovarian syndrome (PCOS) is high. Small studies have shown reductions in serum alanine aminotransaminase (ALT) and gamma-glutamyltransaminase (GGT) concentrations, both surrogate liver fat markers, and sometimes improvements in liver histology in individuals with NAFLD treated with metformin. AIMS: We investigated whether metformin reduces serum ALT and GGT concentrations in obese women with PCOS. METHODS: We performed post hoc data analysis from a trial, involving 82 obese women aged 22-46 years with PCOS, conducted at an academic institution. Participants were treated with metformin 1500 or 2550 mg/day for 8 months. Anthropometric measurements and blood samples (serum ALT, GGT, lipids, leptin, C-reactive protein, insulin, glucose analyses) were taken at baseline, 4 and 8 months. RESULTS: Sixty-six participants completed the study. Mean weight, serum ALT and GGT decreased from 100.3 to 96.6 kg (p < 0.0001), 29.7 to 25.8 U/l (p = 0.012) and 21.4 to 16.9 U/l (p < 0.0001) respectively. Associations between weight reduction and decreases in serum ALT and GGT were highly significant and independent of change in Homeostasis Model Assessment of Insulin Resistance. In women with baseline ALT > 29.7 U/l (median), ALT reduction was highly significant (p = 0.005); however in those with baseline ALT < 29.7 U/l, ALT did not change despite similar weight reduction. There was no difference in reductions in ALT and GGT when the two metformin doses were compared. Intention-to-treat analyses gave comparable results. CONCLUSIONS: Metformin therapy is associated with reductions in surrogate liver fat markers in obese women with PCOS. This adds indirect support for a benefit of metformin in attenuating/reversing liver fat accumulation in PCOS and more generally.
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Metformin's effect on weight in women with PCOS is not as well defined and depends on the population and study design.
“Metformin’s effect on weight in women with PCOS is not as well defined, depending on the population and study design (69–74).”
From GDF-15 as a Weight Watcher for Diabetic and Non-Diabetic People Treated With Metformin (2020) · cites this paper as [70]
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1 retracted
Angelico, F., Burattin, M., Alessandri, C., Ben, M. D., & Lirussi, F. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005166.pub2 · Cited by 115 · see citing works
RetractedReduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · see citing works
Updated definitions of healthy ranges for serum alanine aminotransferase levels
Prati, D., Taioli, E., Zanella, A., Torre, E. D., Butelli, S., Del Vecchio, E., Vianello, L., Zanuso, F., Mozzi, F., Milani, S., et al. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-137-1-200207020-00006 · Cited by 1,445 · see citing works
Nonalcoholic steatohepatitis: An expanded clinical entity
Bacon, B. R., Farahvash, M. J., Janney, C. G., & Neuschwander‐Tetri, B. A. (1994) · Gastroenterology · doi:10.1016/0016-5085(94)90235-6 · Cited by 1,137 · see citing works
Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome
Legro, R. S., Barnhart, H. X., Schlaff, W. D., Carr, B. R., Diamond, M. P., Carson, S. A., Steinkampf, M. P., Coutifaris, C., McGovern, P. G., Cataldo, N. A., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa063971 · Cited by 1,027 · see citing works
Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism.
Adams, J., POLSON, D. W., & Franks, S. (1986) · BMJ · doi:10.1136/bmj.293.6543.355 · Cited by 975 · see citing works
Prevalence and Characteristics of the Metabolic Syndrome in Women with Polycystic Ovary Syndrome
Apridonidze, T., Essah, P. A., Iuorno, M. J., & Nestler, J. E. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1045 · Cited by 931 · see citing works
Metformin in polycystic ovary syndrome: systematic review and meta-analysis
Lord, J. M., Flight, I. H. K., & Norman, R. J. (2003) · BMJ · doi:10.1136/bmj.327.7421.951 · Cited by 786 · see citing works
Bugianesi, E., Gentilcore, E., Manini, R., Natale, S., Vanni, E., Villanova, N., David, E., Rizzetto, M., & Marchesini, G. (2005) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2005.41583.x · Cited by 683 · see citing works
Non-alcoholic fatty liver disease and increased risk of cardiovascular disease
Targher, G., & Arcaro, G. (2006) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2006.08.021 · Cited by 551 · see citing works
Tiikkainen, M., Häkkinen, A.-M., Korsheninnikova, E., Nyman, T., Mäkimattila, S., & Yki-Järvinen, H. (2004) · Diabetes · doi:10.2337/diabetes.53.8.2169 · Cited by 524 · see citing works
Metformin in the treatment of patients with non‐alcoholic steatohepatitis
Uygun, A., Kadayıfçı, A., Işık, A. T., Ozgurtas, T., Deveci, S., Tüzün, A., Yeşilova, Z., Gülşen, M., & Dağalp, K. (2004) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2004.01888.x · Cited by 404 · see citing works
Sattar, N. A., Scherbakova, O., Ford, I., O’Reilly, D. S. J., Stanley, A. J., Forrest, E. H., Macfarlane, P. W., Packard, C. J., Cobbe, S. M., & Shepherd, J. (2004) · Diabetes · doi:10.2337/diabetes.53.11.2855 · Cited by 376 · see citing works
Self-citationWesterbacka, J., Corn�r, A., Tiikkainen, M., Tamminen, M., Vehkavaara, S., H�kkinen, A.-M., Fredriksson, J., & Yki-J�rvinen, H. (2004) · Diabetologia · doi:10.1007/s00125-004-1460-1 · Cited by 338 · see citing works
Moll, E., Bossuyt, P., Korevaar, J., Lambalk, C., & van der Veen, F. (2006) · British medical journal · doi:10.1136/bmj.38867.631551.55 · Cited by 280 · see citing works
Hepatic Enzymes, the Metabolic Syndrome, and the Risk of Type 2 Diabetes in Older Men
Wannamethee, S. G., Shaper, A. G., LENNON, L. T., & Whincup, P. H. (2005) · Diabetes Care · doi:10.2337/diacare.28.12.2913 · Cited by 275 · see citing works
Overweight Women with Polycystic Ovary Syndrome Have Evidence of Subclinical Cardiovascular Disease
Meyer, C., McGrath, B. P., & Teede, H. J. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-0011 · Cited by 273 · see citing works
Tiikkainen, M., Bergholm, R., Vehkavaara, S., Rissanen, A., Häkkinen, A.-M., Tamminen, M., Teramo, K., & Yki-Järvinen, H. (2003) · Diabetes · doi:10.2337/diabetes.52.3.701 · Cited by 271 · see citing works
Chang, Y., Ryu, S., Sung, E., & Jang, Y. (2007) · Clinical Chemistry · doi:10.1373/clinchem.2006.081257 · Cited by 229 · see citing works
Kunde, S. S., Lazenby, A. J., Clements, R. H., & Abrams, G. A. (2005) · Hepatology · doi:10.1002/hep.20818 · Cited by 211 · see citing works
Prevalence of Nonalcoholic Fatty Liver Disease in Women With Polycystic Ovary Syndrome
Gambarin‐Gelwan, M., Kinkhabwala, S. V., Schiano, T. D., Bodian, C., Yeh, H., & Futterweit, W. (2007) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2006.10.010 · Cited by 168 · see citing works
Metformin and Weight Loss in Obese Women with Polycystic Ovary Syndrome: Comparison of Doses
Harborne, L., Sattar, N. A., Norman, J. E., & Fleming, R. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-2283 · Cited by 166 · see citing works
Self-citationPacifico, L., Celestre, M., Anania, C., Paolantonio, P., Chiesa, C., & Laghi, A. (2007) · Acta Paediatrica · doi:10.1111/j.1651-2227.2007.00186.x · Cited by 133 · see citing works
Sattar, N., McConnachie, A., Ford, I., Gaw, A., Cleland, S. J., Forouhi, N. G., McFarlane, P., Shepherd, J., Cobbe, S., & Packard, C. (2007) · Diabetes · doi:10.2337/db06-1256 · Cited by 127 · see citing works
Self-citationAbnormal aminotransferase activity in women with polycystic ovary syndrome
Schwimmer, J. B., Khorram, O., Chiu, V. Y., & Schwimmer, W. B. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.08.020 · Cited by 106 · see citing works
Non-alcoholic fatty liver disease in obese children evaluated by magnetic resonance imaging
Radetti, G., Kleon, W., Stuefer, J., & Pittschieler, K. (2006) · Acta Paediatrica · doi:10.1080/08035250500449890 · Cited by 95 · see citing works
Diabetes Prevalence and Risk Factors in Polycystic Ovary Syndrome
Legro, R. S. (2001) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/s0889-8545(05)70188-1 · Cited by 53 · see citing works
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Research works printed but not linked: 1
- Lipid Research Clinics Program. Lipid and Lipoprotein Analysis. Manual of Laboratory Operations, Vol. 1. Bethesda, MD: DHEW Publications (NIH), 1975, 75.
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Palomba, S., Falbo, A., Zullo, F., & Orio, F. (2009) · Endocrine Reviews · doi:10.1210/er.2008-0030 · Cited by 426 · see citing works
GDF-15 as a Weight Watcher for Diabetic and Non-Diabetic People Treated With Metformin
Ouyang, J., Isnard, S., Lin, J., Fombuena, B., Peng, X., Chen, Y., & Routy, J.-P. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.581839 · Cited by 39 · see citing works
- Authors
- Preiss, D., Sattar, N., Harborne, L., Norman, J., & Fleming, R.
- Affiliations
- Glasgow Royal Infirmary (GB)
- University of Glasgow (GB)
- Corresponding author
- Sattar, N.
- Venue
- International Journal of Clinical Practice
- Publisher
- Hindawi Limited
- Published
- 2008-06-28
- Volume
- 62
- Issue
- 9
- Pages
- 1337-1343
- ISSN
- 1368-5031 (ISSN-L)
- OpenAlex
- W1894869804
- Cited by
- 39
- References
- 27
- Citations by year
- 2024: 3 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 2
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Explore Bristol Research (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- metformin, polycystic ovary syndrome, non-alcoholic fatty liver disease, alanine aminotransferase, gamma-glutamyl transferase, liver fat, obesity, weight loss, insulin resistance
- MeSH terms
- Adult, Alanine Transaminase, Analysis of Variance, Female, gamma-Glutamyltransferase, Humans, Metformin, Middle Aged, Obesity, Polycystic Ovary Syndrome, Biomarkers, Anti-Obesity Agents, Young Adult
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